Guidelines for the Management of Third and Fourth Degree Perineal Tears After Vaginal Birth

Introduction: The purpose of these guidelines is to provide help in decision-making concerning the diagnosis, treatment and follow-up of patients with higher grade perineal tears (perineal tears grades 3 and 4) and thus minimise the risk for persisting complaints. Methods: In 2007 the Austrian Urogynecology Working Group (Arbeitsgemeinschaft fur Urogynakologie und rekonstruktive Beckenbodenchirurgie Osterreich [AUB]) published the “Guidelines for Management of 3rd and 4th Grade Perineal Tears after Vaginal Delivery” („Leitlinie zum Management von Dammrissen III. und IV. Grades nach vaginaler Geburt“). In 2011 the guidelines were updated including literature appearing up to publication date November 30, 2011. The realisation of consensus was supported by the DELPHI method. Results: Evidence-based recommendations founded on consensus were presented on the topics epidemiology, risk factors, classification, diagnosis, surgical management and follow-up of higher grade perineal tears (grade 3 and 4 perineal tears) after vaginal delivery.